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New Treatments For Cold Sores

642x361_Cold_SoresNew Treatments For Cold Sores

If you suffer from cold sores, you are not alone. Nearly 70% of Americans ages 12 and older test positive for herpes simplex virus type 1 (HSV-1), the virus that causes cold sores. At least 20% of patients with HSV experience recurring cold sores.

HSV-1 is transmitted by direct contact with infected skin or saliva. A primary infection usually occurs during childhood and causes a fever, sore gums, sore throat and swollen or tender glands in the neck. After that, the virus remains dormant in nerve roots near the infected skin. In some people, the virus rarely, if ever, reactivates. But in others, recurrences called secondary herpes episodes occur frequently, producing cold sores. While medical experts have not determined the exact cause for reactivation, a variety of stimuli, such as stress, dental treatment, illness, trauma to the lips or sun exposure can precipitate an outbreak.

“While there is no cure for cold sores, there are medications that can be useful in their treatment and prevention,” says Joel Laudenbach, D.M.D., assistant professor and director of geriatric dentistry at the Columbia University School of Dental and Oral Surgery.

Three oral antiviral medications sometimes prescribed are acyclovir (Zovirax), famciclovir (Famvir) and valacyclovir (Valtrex). Although none of these medications will eliminate the dormant HSV-1 infection that causes cold sores, they can help the sores heal faster and relieve the associated pain and discomfort. They also can also help to suppress a cold-sore outbreak.

These drugs also are effective in helping to prevent an outbreak of cold sores during a time of increased susceptibility, such as a beach or ski vacation that would involve extensive sun exposure. In addition, recent studies have shown that using valacyclovir before certain dental procedures can help decrease recurrent outbreaks. Other treatments include topical antiviral creams and ointments, such as penciclovir (Denavir) cream. Some research demonstrates that penciclovir appears to reduce the average size and duration of a cold sore.

Penciclovir reportedly is best used as soon as possible after symptoms (pain, tingling, itching, burning or blisters) begin to appear. Although the recommended dose varies with the individual, the average adult dose calls for applying the cream to the affected areas every two hours, while awake, for four days.

A topical acyclovir ointment also can be used for symptoms of HSV infections of the skin, mucous membranes, and genitals.

Cold sores and canker sores are not the same, Dr. Laudenbach says. Canker sores occur only inside the mouth, are not caused by a virus, and are not contagious. Cold sores usually occur outside the mouth on the lips, are caused by a virus (herpes simplex virus [HSV-1]), and are contagious, he says. Because canker sores are not caused by a virus, antiviral medications will not be effective in treating them.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Important Reasons for Mouth Guards

Important Reasons for Mouth Guards

A mouth guard is a soft plastic or laminate device used in sports to prevent oral injuries to the teeth, mouth, cheeks, tongue and jaw. The American Dental Association projects that one third of all dental injuries are sports related.1 The use of a mouth guard can prevent more than 200,000 oral injuries to the mouth each year.

The types of dental injuries that can occur without the use of a mouth guard are chipped or broken teeth, fractured crowns or bridgework, lip and cheek injuries, root damage to the teeth, fractured jaws, and concussions. Any athlete may be at risk for oral injury and any injury can be prevented with the use of a mouth guard.

Mouth guards are mandatory in collision sports such as football, hockey and boxing where the risk of injury is likely. Children and adults involved in incidental contact sports like basketball, baseball, softball, wrestling, soccer and volleyball may consider wearing a mouth guard to prevent injuries to the mouth.

A study of high school athletes found that seventy-five percent of injuries occurred when mouth guards were not worn and forty percent occurred during baseball and basketball. Nine percent of all athletes suffered some type of oral injury while another three percent reported a loss of consciousness. Fifty-six percent of all concussions were suffered when mouth guards were not worn. Trauma related to sports is more prevalent than previously reported.2

Child or adult, a mouth guard is essential for all athletes. For more information about the right mouth guard for you, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Treatment Options for Tooth Sensitivity

Tooth Sensitivity – Overview

Tooth sensitivity is due to the exposure of dentin, the part of the tooth which covers the nerve, either through loss of the enamel layer or recession of the gums. Temperature changes and certain foods (acidic or sweet) can cause the tooth or teeth to be painful. The pain usually subsides after a short period of time.

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When the dentin is exposed, these tubes can be stimulated by changes in temperature or certain foods. Here is an image of what the dentin tubes look like under the microscope:

The dentin contains a large numbers of pores or tubes that run from the outside of the tooth to the nerve in the center. When the dentin is exposed, these tubes can be stimulated by changes in temperature or certain foods. Here is an image of what the dentin tubes look like under the microscope:

Tooth dentin

The best way to find out why a tooth is sensitive is to have dental professional examine you. They can look for the signs of dentin exposure, and run tests to determine what the true cause of the sensitivity is. Sometimes, the sensitivity is due to a cavity or gum disease – these can be treated to address the sensitivity. Other times, the cause of the sensitivity is because the enamel has been lost through abrasion or erosion, or the gums have receded, causing the roots to be exposed.

What Can Be Done?

If the sensitivity is due to a cavity, a restoration can be placed. If gum disease is the cause, the dental professional can perform a thorough cleaning of the area.

However, if the cause is from dentin being exposed, then there are a number of professional and at home treatments that can be used to reduce the sensitivity.

  • In Office Procedures:
    • Fluoride varnish can be applied to exposed areas, strengthening the enamel and dentin
    • Fluoride foam or gel can be placed into a mouth tray; you then sit with this in your mouth for 3-5 minutes, providing the teeth with a high concentration of fluoride to strengthen the areas
    • Bonding agent, the material used to stick tooth colored restorations to teeth, can be used to seal the dentin surface and provide a barrier to the stimuli that cause sensitivity
  • At Home:
    • Use a very soft bristle tooth brush, with low abrasive tooth paste
    • Brush correctly and do not over brush
    • Use a tooth paste specially formulated to soothe the nerve endings in the tooth
    • Use a high concentration fluoride toothpaste (given to you by the dental professional) to strengthen the tooth surface

There are a number of treatments available, and your dental professional can help you find those that will work best, depending on your situation. Always seek a dental professional’s help – do not try to diagnose this problem yourself. It may be the sign of something more serious, and only a dental professional can tell you what it really is.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Too Much Drilling? Not All Early Tooth Decay Needs A Filling

To find tooth decay early, some dentists are using newer technologies, in addition to visual exams and X-rays. The devices claim to be able to detect the beginnings of decay, when the tooth begins to soften, before it turns into a cavity.

As with almost any new technology, the devices are expensive. Are they worth it? More importantly, if one of these devices shows that you have early decay, do you need a filling right away?

Not necessarily.

Dental decay is “a slowly progressing disease,” says David A. Albert, D.D.S., M.P.H., associate professor of clinical dentistry at the Columbia University School of Dental and Oral Surgery. “From start to finish in the general population, it can take five years to go from a new caries lesion (early decay) to full-blown involvement of the pulp (the center of the tooth, where the nerves and blood vessels are). Back in the 1920s, the way we practiced was based on [decay] progression taking a matter of months.”

So early decay doesn’t always mean you need a filling. In fact, the decay often can be reversed. A tooth starts to decay because acid in your mouth causes minerals to leach out of the enamel, and the enamel breaks down. Fluoride therapy, dietary changes and better oral hygiene habits can reverse this process by causing minerals to build up in the tooth again, making the enamel stronger.

In some cases, a filling is a no-brainer. If you’re in pain or have an obvious cavity (a break in the surface of your tooth), you need a filling. But, says Dr. Albert, “If there’s no cavity and no pain, the tooth can fix itself.

“If I saw 100 patients [who had early decay] and decided to wait six months before treating them, it would be the right decision for 95 of them. I think we do more harm by overtreating, because there will always be complications of treatment,” he says.

Once a tooth has a filling in it, there is always a chance the filling will crack, break or fall out. A space left between the filling and the tooth is a hot spot for further decay. Eventually, the tooth may need endodontic (root canal) treatment or may even need to be extracted.

Dr. Albert suggests that using the new technologies should actually lead to fewer fillings for most people, because early decay can be reversed with fluoride treatments or new oral hygiene habits. The reality may be different.

“Dentists who use these machines may actually do more [fillings],” he says. “For the general population, that’s wrong, although for some high-risk individuals, it’s good to find [decay] early and treat it early. But if you’re in a low-risk category, the treatment of choice is to do nothing.”

So why don’t most dentists watch and wait? They may be worried that the person won’t return in six months for another checkup. Or they may be worried that they will be perceived as indecisive or inexperienced.

Also, the detection devices aren’t always right. “Some things look like cavities, but they’re not,” Dr. Albert says. “A dark discoloration does not mean a cavity.”

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Soft Tissue Injuries

The soft tissues in the mouth are delicate and sensitive, and when they are injured, it can be very painful. Soft tissues, which include the tongue, cheeks, gums and lips, can be injured when you accidentally bite down on them, if you fall, are in an accident, or if you put food in your mouth that is too hot. Chewing on hard objects also can damage soft tissues.

What You Can Do

Soft tissue injuries usually do not bleed a lot, but when they do, the injury can seem worse than it really is. When the blood mixes with saliva, it may look like you are bleeding a lot. In most cases, the bleeding should stop within a few minutes. In the meantime, here’s what you should do:

  • Rinse your mouth thoroughly with a mild saltwater solution (1/2 teaspoon of salt in 8 ounces of water).
  • If the bleeding continues, press a damp piece of gauze against the injured area for 10 to 15 minutes. If you don’t have gauze, you can use a sanitary napkin, tampon or a clean piece of material that will soak up blood and saliva.
  • To relieve pain, slow the bleeding, and reduce swelling, hold ice to the area for five or 10 minutes.
  • If the bleeding doesn’t stop within a few minutes, the injury may be serious and you will need to see a doctor, preferably an oral and maxillofacial surgeon, right away. Maintain pressure on the area until you can be treated.

What Your Dentist Will Do

Dentists are trained to diagnose and repair damage to the soft tissues, but doctors and oral surgeons in hospital emergency rooms usually handle serious injuries to these areas.

The doctor or oral surgeon will wash the area thoroughly and determine whether the teeth are loose or damaged. If the teeth are not damaged and the injury is limited to the gum or other soft tissues, you may need stitches to close the wound and control the bleeding. In most cases, stitches will not be necessary, and the doctor will only need to wash the area thoroughly and remove any dirt or debris.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Should You Have Your Wisdom Teeth Removed?

Jennifer Flach was a college junior when her wisdom teeth started making themselves known.

“My other teeth started moving around,” she remembers. “The wisdom teeth were pushing out and undoing some of the orthodontic work I had done in high school.”

At the same time, her brother — who’s two years younger and was also in college — had no symptoms. But the family dentist suggested his wisdom teeth should come out too.

Jen and her brother had back-to-back wisdom tooth extractions and recovered together at home during spring break. “It was quite a week at my parents’ house,” she says.

Patrick Grother was 26 when his dentist mentioned that his wisdom teeth might need to be removed. His bottom left wisdom tooth had partially erupted into his mouth and a flap of gum still covered it. “The dentist said food would get trapped there and it could get infected,” he says. Patrick then visited a periodontist, who said that the gum flap could be cut away but it would grow back.

“I put it off for awhile,” Patrick said, but he eventually had the wisdom teeth on the left side of his mouth extracted.

A few people are born without wisdom teeth or have room in their mouths for them, but like Jen and her brother, many of us get our wisdom teeth taken out during our college years. And like Patrick, many of us are first alerted to the problem when our wisdom teeth don’t emerge (erupt) into the mouth properly because there is not enough toom for them to fit.

“A part of the tooth may remain covered by a flap of gum, where food particles and bacteria can get trapped, causing a mild irritation, a low-grade infection called pericoronitis and swelling,” says Dr. Donald Sadowsky, professor emeritus of clinical dentistry College of Dental Medicine and the Mailman School of Public Health. This usually happens with the lower wisdom teeth. Pericoronitis and the pain it causes is the most common reason people need their wisdom teeth taken out.

Pericoronitis is just one of the reasons that you may need to have a wisdom tooth or more than one removed.

In many people, the wisdom teeth never even partially enter the mouth. Often the teeth are tilted under the gum and blocked from coming in by bone or other teeth. Dentists call these impacted teeth; they may cause pain, but you may feel nothing at all for years. You may not even be aware that you have wisdom teeth until your dentist sees them on an X-ray.

Regular dental visits are important during your teens and early twenties because this is the time when teeth are most likely to decay. Regular visits allow your dentist to follow the progress of your wisdom teeth with X-rays.

Even if your wisdom teeth aren’t causing any pain or other problems, they may cause problems at some point. The most common problems are decay, infection, and crowding or damage to other teeth. But more serious complications can occur, including the development of a cyst that can cause permanent damage to bone, teeth and nerves.

However, not all wisdom teeth need to be removed.

If removing wisdom teeth is necessary, it’s easier in younger people because the tooth roots are not fully developed and the bone in which the teeth sit is less dense. Extracting your wisdom teeth before any complications develop also allows for shorter recovery time and less discomfort after the surgery.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Plaque — What It Is And How To Get Rid Of It

People used to think that as you got older you naturally lost your teeth. We now know that’s not true. By following easy steps for keeping your teeth and gums healthy – plus seeing your dentist regularly — you can have your teeth for a lifetime!

Plaque: What is it?

Plaque is made up of invisible masses of harmful germs that live in the mouth and stick to the teeth.

  • Some types of plaque cause tooth decay
  • Other types of plaque cause gum disease

Red, puffy or bleeding gums can be the first signs of gum disease. If gum disease is not treated, the tissues holding the teeth in place are destroyed and the teeth are eventually lost.

Dental plaque is difficult to see unless it’s stained. You can stain plaque by chewing red “disclosing tablets,” found at grocery stores and drug stores, or by using a cotton swab to smear green food coloring on your teeth. The red or green color left on the teeth will show you where there is still plaque—and where you have to brush again to remove it. Stain and examine your teeth regularly to make sure you are removing all plaque.

Ask your dentist or dental hygienist if your plaque removal techniques are okay.

Step One: Floss

Use floss to remove germs and food particles between teeth. Rinse.

Holding floss. Using floss between upper teeth. Using floss between lower teeth.

NOTE! Ease the floss into place gently. Do not snap it into place — this could harm your gums.

Step Two: Brush Teeth

Use any tooth brushing method that is comfortable, but do not scrub hard back and forth. Small circular motions and short back and forth motions work well. Rinse.

To prevent decay, it’s what’s on the toothbrush that counts. Use fluoride toothpaste. Fluoride is what protects teeth from decay.

Brush the tongue for a fresh feeling! Rinse again.
Remember: food residues, especially sweets, provide nutrients for the germs that cause tooth decay, as well as those that cause gum disease. That’s why it is important to remove all food residues, as well as plaque, from teeth. Remove plaque at least once a day — twice a day is better. If you brush and floss once daily, do it before going to bed.

Another way of removing plaque between teeth is to use a dental pick — a thin plastic or wooden stick. These sticks can be purchased at drug stores and grocery stores.
Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.
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Pericoronitis

Wisdom teeth do not always emerge (erupt) into the mouth properly because there may not be enough room in the mouth for them to fit. Sometimes, a part of the tooth may remain covered by a flap of gum. Food particles and bacteria can get trapped under this flap and cause a mild irritation, a low-grade infection called pericoronitis and swelling. This usually happens with the lower wisdom teeth.

What You Can Do

You cannot treat pericoronitis at home. Do not use warm compresses on your face. If you recognize the symptoms, get treatment right away. The symptoms may include:

  • A bad taste in the mouth — This often happens when there’s an infection.
  • Bad breath (halitosis)
  • Pain in the area around your back teeth — Pericoronitis usually occurs around the wisdom teeth.
  • Swelling behind the very back teeth — If you have pericoronitis, you’ll notice that the gum tissue in the back of your mouth is swollen. This swelling may not allow you to bite comfortably without pinching the swollen tissues between your teeth.
  • Not being able to open your mouth fully

What Your Dentist Will Do

Pericoronitis can be tricky to treat because the overlying flap in the tissue won’t go away until the wisdom tooth fully emerges naturally — which is unlikely to happen — or is removed by an oral surgeon.

Your dentist, however, may try to treat the problem without extensive procedures. He or she will clean the area thoroughly to remove damaged tissue or pus. If the area is infected, you’ll be given oral antibiotics as well.

Your dentist will tell you how to keep the area clean, which is the best way to prevent the problem from coming back. You will have to brush and floss every day and also rinse your mouth with water several times a day. This will help to prevent food particles from building up in the area.

If the condition returns, your dentist probably will send you to an oral surgeon, who will remove the tooth. Once the tooth is out, you should not have the problem again. If the problem is caused by an upper wisdom tooth biting the gum covering a lower wisdom tooth, the upper one may be removed first.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Mouth-Healthy Eating

If you want to prevent cavities, how often you eat can be just as important as what you eat. That’s because food affects your teeth and mouth long after you swallow. Eating cookies with dinner will do less harm to your teeth than eating them in the middle of the afternoon as a separate snack. Of course, overall poor nutrition can contribute to periodontal (gum) disease and can have other long-term effects on your mouth. Learning how food affects your oral health — long-term and short-term — is the first step toward mouth-healthy eating.

Immediate Effects of Food

Changes begin in your mouth the minute you start to eat certain foods. Bacteria in your mouth make dental plaque become more acidic, and the acid starts the process that can lead to cavities.

How does this happen?

All carbohydrate foods eventually break down into simple sugars: glucose, fructose, maltose and lactose. Some foods, called fermentable carbohydrates, break down in the mouth, whereas others don’t break down until they move further down the digestive tract.

It’s the fermentable carbohydrates that work with bacteria to begin the decay process and eventually destroy teeth. They include the obvious sugary foods, such as cookies, cakes, soft drinks and candy, but they also include less obvious food, such as bread, crackers, bananas and breakfast cereals.

Certain bacteria on your teeth use the sugars from these foods and produce acids. These acids dissolve minerals inside the tooth enamel in a process called demineralization. Teeth also regain minerals in a natural process called remineralization. Saliva helps this process, as does fluoride and some foods.

Dental decay begins inside the tooth enamel when minerals are being lost faster than they are being regained.

The longer food stays near the bacteria on the tooth, the more acids will be produced. So sticky carbohydrates, such as raisins, can do more acid damage. But other foods that pack into crevices can also cause decay. Potato chips are a terrific example. Eat a handful of chips and see how long you have to work to get all the stuck bits out from between your teeth. Teeth with a lot of nooks and crannies, such as molars, are more likely to trap food and are more susceptible to decay.

To make matters worse, tooth-unhealthy foods don’t create acids on your teeth only while they are being eaten. The acids stick around for the next half-hour.

People who sip soft drinks or sweetened coffee throughout the day or who eat many small sweet or carbohydrate snacks provide a sugar source for the bacteria to produce acid almost constantly. And because acid damage is cumulative, decay is more likely. Studies have shown that those who eat sweets as snacks between meals have higher incidences of decay than those who eat the same amount of sweets with their meals.

On the brighter side, some foods actually help to protect teeth from decay because they increase saliva flow and neutralize the acids produced by bacteria, making the enamel less likely to be demineralized. For example, aged cheese eaten immediately after other food helps buffer the acid. That’s another reason why eating sweets between meals causes more cavities. Between-meal snackers not only have an overall longer period when their teeth are exposed to acid, they don’t eat other foods with the snack to moderate the effects of the sugar.

Chewing sugarless gums also can help protect your teeth against cavities. Xylitol, an ingredient in some sugarless gums, has been shown to reduce the amount of bacteria in the mouth and help buffer the teeth against the effect of acid. Most sugarless gums and sugarless candies increase the flow of saliva, which has natural antibacterial properties.

Long-Term Effects

Like the rest of your body, your mouth depends on overall good nutrition to stay healthy. In fact, your mouth is highly sensitive to poor nutrition, which can lead to premature tooth loss, serious periodontal (gum) disease and bad breath. Many nutritional problems will affect the mouth before the rest of the body. This is because the cells in the lining of the mouth — called the oral mucosa — are constantly being created and destroyed. In some areas of the mouth, cells completely turn over, with a whole new group of cells taking the place of old cells, in three to seven days.

What To Eat

The current and best recommendation for overall good nutrition is to follow the Dietary Guidelines for Americans, developed by the U.S. Department of Agriculture and the Department of Health and Human Services. The guidelines are simple in concept:

  • Eat whole grains daily, such as brown rice, oatmeal and whole wheat bread instead of refined grains, such as white bread and white rice.
  • Eat healthier vegetables, including dark green and orange vegetables.
  • Eat a variety of fruits.
  • Choose a diet with plenty of grain products, fruits and vegetables.
  • Choose fish, beans, nuts and seeds for some of your protein needs.
  • Choose beverages and foods to moderate your intake of sugars.
  • Choose and prepare foods with less salt.
  • If you drink alcoholic beverages, do so in moderation.
  • Aim for a healthy weight and be physically active each day.

To help people understand these guidelines, the USDA has replaced the old Food Guide Pyramid with a new, interactive tool called MyPyramid. The new tool is actually many different pyramids customized for a person depending on age, gender and physical activity.

Your diet, like the pyramid, should have a strong base of grains; at least 2½ cups of vegetables a day; at least 2 cups of fruits a day; at least 3 cups of calcium-containing milk, yogurt and cheese; and proteins such as meats, beans, eggs and nuts. Eat fats and sweets sparingly.

To prevent tooth decay, you should follow a few additional guidelines to keep the amount of acid created by the bacteria on your teeth to a minimum. Here are some tips:

  1. Limit between-meal snacking to reduce the amount of time your teeth are exposed to acid. If you snack, choose foods that are not fermentable carbohydrates.
    • Best choices — Cheese, chicken or other meats, nuts or milk. These foods may actually help protect tooth enamel by counteracting acidity or by providing the calcium and phosphorus needed to remineralize teeth.
    • Moderate choices — Firm fruits like apples and pears and vegetables. Although firm fruits contain natural sugars, they have a high water content that dilutes the effects of the sugars and they stimulate the flow of saliva, which has antibacterial factors and helps protect against decay. Vegetables do not contain enough carbohydrates to be dangerous.
    • Worst choices — Candy, cookies, cakes, crackers, breads, muffins, potato chips, french fries, pretzels, bananas, raisins and other dried fruits. These foods provide a source of sugar for certain bacteria on the teeth to produce acid. The problem can be worse if the foods stick to or get caught between teeth.
  2. Limit the amount of soft drinks or any other sugar-containing drinks, including coffee or tea with added sugar, cocoa and lemonade. Fruit juices contain natural sugars that can also cause decay. Limit the amount of time you take to drink any of these drinks and avoid sipping them throughout the day. A can of soda finished with a meal is better than a can of soda finished over two hours because your teeth are exposed to high acid levels for a shorter amount of time.
    • Better choices — Unsweetened tea, milk and water, especially fluoridated water. Tea also has fluoride, which can strengthen tooth enamel and milk can also help deter decay. Water helps flush away food debris and can dilute the sugar acids.
  3. Avoid sucking on hard candies or mints, even the tiny ones. They have enough sugar to increase the acid produced by bacteria to decay levels. If you need a mint, use the sugarless varieties.
  4. Very acidic foods (such as citrus fruits) can make the mouth more acidic and may contribute to tooth demineralization and erosion. The effects of acid exposure are cumulative, so every little bit counts.
  5. Brush your teeth after eating to remove the plaque bacteria that create the destructive acids. If you cannot brush after every meal, brush at least twice a day to thoroughly remove all plaque bacteria.
  6. Chewing sugarless gum that contains xylitol can help reduce the risk of cavities. It not only helps dislodge some of the food stuck to your teeth, it also increases saliva flow to help buffer the acids.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Illustrations: How A Tooth Decays

Illustrations: How A Tooth Decays

Healthy Tooth
Healthy Tooth
Enamel is the hard outer crystal-like layer. Dentin is the softer layer beneath the enamel. The pulp chamber contains nerves and blood vessels and is considered the living part of the tooth.

White Spots
White Spots
Bacteria that are exposed to sugars or carbohydrates can make acid, which attacks the crystal-like substance in the tooth’s outer surface. This process is known as demineralization. The first sign of this is a chalky white spot. At this stage, the decay process can be reversed. Using fluorides at home and in the dental office can help the tooth repair itself.

Enamel Decay
Enamel Decay
Demineralization continues. Enamel starts to break down. Once the enamel surface is broken, the tooth can no longer repair itself. The cavity has to be cleaned and restored by a dentist.

Dentin Decay
Dentin Decay
The decay reaches into the dentin where it can spread and undermine the enamel.

Pulp Involvement
Pulp Involvement
If decay is left untreated, it will reach the tooth’s pulp, which contains nerves and blood vessels. The pulp becomes infected. An abscess (swelling) or a fistula (opening to the surface of the gum) can form in the soft tissues.

For more information, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.